After a self- limited course, CMV establishes latency in a wide vari- ety of cells, including endothelial cells, epithelial cells, smooth-muscle cells, and fibroblasts, where the virus can multiply and may be carried by peripheral monocytes and circulating endothelial cells to reach distant sites of the body ( 12). The initial infection leads to production of CMV-specific IgM and, later, IgG antibody that persists for life ( 13).